The national age-adjusted Alzheimer's disease death rate per 100,000 population increased from 16.5 to 25.4 between 1999 and 2014—nearly a 54% increase.
This article first appeared May 25, 2017 on Medpage Today.
by Alexandria Bachert
Death rates from Alzheimer's disease in the U.S. increased 55% over the past two decades, with a significant increase in the percentage of deaths occurring at home, reported researchers.
The national age-adjusted Alzheimer's disease death rate per 100,000 population increased from 16.5 (44,536 deaths) in 1999 to 25.4 (93,541 deaths) in 2014.
Over this 16-year period, the majority of deaths due Alzheimer's disease continued to occur in a nursing home or long-term care facility, but the percentage occurring in these institutional settings decreased from 68% to 54%, reported Christopher A. Taylor, PhD, of the CDC, and colleagues.
Conversely, the percentage of patients who died at home increased from 13.9% in 1999 to 24.9% in 2014, they wrote online in the CDC's Morbidity and Mortality Weekly Report.
"Our new study reveals an increase in the incidence of Alzheimer's disease-related deaths. As the number of older Americans with Alzheimer's disease rises, more family members are taking on the emotionally and physically challenging role of caregiver than ever before. These families need and deserve our support," CDC Acting Director Anne Schuchat, MD, stated in a press release.
Taylor and colleagues analyzed state- and county-level death certificate data from the National Vital Statistics System from 1999 to 2014 to identify deaths with Alzheimer's disease reported as the underlying cause.
Age-adjusted rates of Alzheimer's mortality significantly increased for 41 states and the District of Columbia -- with country-wide rates ranging from 7.0 to 29.8 per 100,000 in 1999 and from 10.7 to 43.6 per 100,000 in 2014.
Using average annual county-level data, the researchers found that from 1999 to 2014 the age-adjusted rates of Alzheimer's deaths ranged from 4.3 to 123.7 per 100,000. Counties with the highest age-adjusted rates were primarily in the Southeast, followed by some additional areas in the Midwest and West.
Age-wise, the sharpest increases in Alzheimer's disease mortality were seen in those younger than 65 and those 85 and older. For both age groups, mortality rates rose more than 60% during the study period.
Explanations for the findings could include increases in diagnosis of Alzheimer's disease at earlier stages, increased reporting of the cause of death, and fewer deaths from other causes such as heart disease and stroke, noted the researchers.
The CDC concluded that the increase in caregivers tending to dying patients at home calls for better interventions -- such as education, respite care, and home health assistance -- to help them provide care.
"As Alzheimer's disease progresses, caregiving becomes very important. Caregivers and patients can benefit from programs that include education about Alzheimer's disease, how to take care of themselves and their loved one, and case management to lessen the burden of care," stated Taylor.
"Supportive interventions can lessen the burden for caregivers and improve the quality of care for people with Alzheimer's disease," he added.
Limitations were that death certificates might have underestimated the actual number of Alzheimer's deaths in the U.S., as well as that complications from Alzheimer's, such as pneumonia, might have been reported without mentioning Alzheimer's disease. Additionally, for some individuals with Alzheimer's disease, death certificates may have merely listed "dementia" as the cause and these were not counted in the study.